Frozen shoulder
Frozen shoulder, also called adhesive capsulitis, is one that has become stuck and limited in movement. It involves stiffness and pain in the shoulder joint and often caused by inflammation of the capsule, tissue surrounding the shoulder joint. Diagnosing frozen shoulder requires a physical examination and possible X-rays or additional tests to rule out other causes of symptoms.
Signs and symptoms typically begin slowly, then get worse. Over time, symptoms get better, usually within 1 to 3 years.
Having to keep a shoulder still for a long period increases the risk of developing frozen shoulder. This might happen after having surgery or breaking an arm.
Treatment for frozen shoulder involves range-of-motion exercises. Sometimes treatment involves corticosteroids and numbing medications injected into the joint. Rarely, arthroscopic surgery is needed to loosen the joint capsule so that it can move more freely.
It's unusual for frozen shoulder to recur in the same shoulder. But some people can develop it in the other shoulder, usually within five years.
Symptoms
Frozen shoulder typically develops slowly in three stages.
· Freezing stage. Any movement of the shoulder causes pain, and the shoulder's ability to move becomes limited. This stage lasts from 2 to 9 months.
· Frozen stage. Pain might lessen during this stage. However, the shoulder becomes stiffer. Using it becomes more difficult. This stage lasts from 4 to 12 months.
· Thawing stage. The shoulder's ability to move begins to improve. This stage lasts from 5 to 24 months.
For some people, the pain worsens at night, sometimes disrupting sleep.
Causes
· The shoulder joint is enclosed in a capsule of connective tissue. Frozen shoulder occurs when this capsule thickens and tightens around the shoulder joint, restricting its movement.
· It's unclear why this happens to some people. But it's more likely to happen after keeping a shoulder still for a long period, such as after surgery or an arm fracture.
Risk factors
· Certain factors may increase the risk of developing a frozen shoulder.
· Age and sex
· People 40 and older, particularly women, are more likely to have frozen shoulder.
· Immobility or reduced mobility
· People who've had to keep a shoulder somewhat still are at higher risk of developing frozen shoulder.
Restricted movement can be the result of many factors, including:
· Rotator cuff injury
· Broken arm
· Stroke
· Recovery from surgery
· Systemic diseases
· People who have certain diseases appear more likely to develop frozen shoulder. Diseases that might increase risk include:
· Diabetes
· Overactive thyroid (hyperthyroidism)
· Underactive thyroid (hypothyroidism)
· Cardiovascular disease
· Parkinson's disease
· Prevention
· One of the most common causes of frozen shoulder is not moving a shoulder while recovering from a shoulder injury, broken arm or stroke. If you've had an injury that makes it difficult to move your shoulder, talk to your health care provider about exercises that can help you maintain your ability to move your shoulder joint.
· About trigger points and frozen shoulder syndrome
· Myofascial trigger points in the muscles of the shoulder and surrounding areas can cause frozen shoulder.
· Trigger points are muscle knots, lumps, or sensitive areas that can occur due to injury, overuse, or referred pain from another area of your body. They can cause pain, reduced mobility, and muscle weakness. Trigger points can also lead to poor circulation, contractions, and spasms.
· There are certain trigger points connected to frozen shoulder. Learning about these specific areas may help you to understand how to treat frozen shoulder.
· Trigger points related to frozen shoulder are found in any of the shoulder or arm muscles. These diagrams show the common trigger points for frozen shoulder (front and back).
Benefits of massage and stretching for frozen shoulder
· Massage and stretching are extremely beneficial for treating frozen shoulder pain.
· Massage helps to relieve tension and tightness so your muscles can relax. This helps to restore mobility and improve function. It also may help improve blood flow to the affected area and reduce inflammation.
· Stretching improves flexibility, increases range of motion, and lengthens muscle fibers.
· Both of these treatments can alleviate pain and discomfort. This allows you to feel more at ease as you go about your daily activities, so you’re more likely to stay active.
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Treatment goals for a frozen shoulder
· Frozen shoulder, technically called adhesive capsulitis, is a common condition that causes stiffness, pain, and discomfort in your shoulder joint. It occurs when the range of motion of your shoulder joint is reduced to the point that it feels as though your shoulder is frozen.
· Frozen shoulder usually affects people between the ages of 40 and 70. Inflammation, repetitive motions, or extended periods of disuse cause it. Lack of mobility, when you’re healing from a medical condition, procedure, or injury, can also be a cause. At times the cause is unknown.
· Initially, the symptoms of this syndrome are minor but progressively get worse. Due to the discomfort and loss of range of motion, people who have frozen shoulder tend to use their shoulder less, which further reduces mobility.
· Not using your shoulder can exacerbate your symptoms, so it’s important to keep your shoulder mobile. Massages and stretches can increase your range of motion and alleviate pain.
· When to seek help
· If you have pain that’s long lasting and gets in the way of your daily activities, see a doctor to diagnose your condition. They’ll ask about your symptoms, previous injuries, and any activities that exacerbate your condition.
· A doctor can observe your active and passive range of motion. Usually, they’ll be able to diagnose your condition based on your signs and symptoms. If necessary, they’ll do an imaging test such as an X-ray, MRI, or ultrasound to eliminate other causes.
· Your doctor may also refer you to a physical therapist and massage therapist near you, who can create an individual treatment plan.
· Key takeaways
· Frozen shoulder is a common condition that can become serious if it’s not treated correctly. You can treat this condition with specific massages and stretches. It’s best to do these with the instruction of a doctor or physical therapist.
· Stay active during your recovery and be patient since it can take several months to fully heal a frozen shoulder.
Massage for frozen shoulder
It is believed that Swedish massage can increase oxygen levels in the blood, which promotes circulation and can speed injury recovery.
Because it uses long, kneading strokes and light pressure, Swedish massage can be quite relaxing and energizing, which is why it is so popular. But there is no anecdotal or clinical evidence to suggest that Swedish massage is an effective treatment for frozen shoulder.
Deep Tissue Massage
This approach to massage is often used to treat sports injuries and to help athletes recover from intense training sessions. It uses heavy, sustained pressure and slow strokes to reach deep into muscles and connective tissues to break up scar tissue and reduce tension.
Trigger Point Therapy
This type of massage is used to manage muscular pain. Trigger points are painful spots found in muscle tissue that result from acute trauma or repetitive microtrauma. Identifying and breaking up these trigger points is an effective pain management approach for many conditions, but it lacks the specificity of a frozen shoulder treatment.
People who suffer from frozen shoulder can find some relief using trigger point therapy, however, it will not cure adhesive capsulitis.
PERFORMING FROZEN SHOULDER MASSAGE ON YOURSELF
The persistent pain and joint stiffness associated with a frozen shoulder often lead people to seek remedies and treatments they can perform at home. Although self-massage will not resolve a frozen shoulder, it can relieve short-term pain.
Here is how you can perform a frozen shoulder massage on yourself, using only a foam roller, to help manage your shoulder pain:
Place a foam roller in the armpit of the affected arm
Using a table or countertop for support, gently lean your weight onto the foam roller
Extend your arm and slowly start to roll back and forth
As your shoulder tension begins to release, put more weight on to the roller and try to rotate your upper arm back and forth as you roll
If this approach is too painful or difficult, vibrating electric massagers can also be used to treat trigger points and relieve shoulder pain.
As with any home treatment, always respect your body’s limits and consult with your primary health care practitioner before starting.
· Foam roller shoulder massage
· Place a foam roller under the underarm of your affected arm.
· Lengthen your arm, keeping the hand of your affect arm extended upward.
· Roll back and forth a few times.
Hand-behind-back stretch
· This stretch requires more mobility, so you may not be able to do it right away.
· From standing, place your affected arm behind your back.
· Use your opposite hand to take hold of this wrist.
· Gently stretch your affected arm by moving it toward the opposite buttock.
· Gently move it as far up as possible.
· Hold this position for a few seconds.
· Repeat 5 times. Cross-body reach
· From sitting or standing, place your unaffected hand on your affected elbow.
· Draw your affected arm across your body.
· Use gentle pressure to lift your elbow and stretch your shoulder.
· Hold the stretch for 20 to 30 seconds.
Hand-behind-back stretch
· This stretch requires more mobility, so you may not be able to do it right away.
· From standing, place your affected arm behind your back.
· Use your opposite hand to take hold of this wrist.
· Gently stretch your affected arm by moving it toward the opposite buttock.
· Gently move it as far up as possible.
· Hold this position for a few seconds.
· Repeat 5 times. Cross-body reach
· From sitting or standing, place your unaffected hand on your affected elbow.
· Draw your affected arm across your body.
· Use gentle pressure to lift your elbow and stretch your shoulder.
· Hold the stretch for 20 to 30 seconds.
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